DR. JERRY BARTOLOME (NPI# 1225176019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225176019 |
| Entity Type | Individual |
| Full Name | DR. JERRY BARTOLOME |
| Credential | D.D.S. |
| Practice Address |
302 California Ave Suite 204 Wahiawa HI 96786-1841 |
| Mailing Address |
95-1067 Hoalia St Mililani HI 96789-6558 |
| Practice Telephone | 8086222633 |
| Practice Fax Number | 8086222342 |
| Mailing Telephone | 8083849273 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DT-1914 | HI | Dental Providers |
| Street Address |
302 CALIFORNIA AVE SUITE 204 |
| City | WAHIAWA |
| State | HI |
| Zip Code | 96786-1841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689675506 | Hugh Norman Hazenfield | Specialist | 302 California Ave, Suite 216, Wahiawa, HI 96786-1841 | 2005-08-02 |
| 1922630292 | Michelle Ushio | Pharmacist | 302 California Ave, Wahiawa, HI 96786-1841 | 2020-02-05 |
| 1689047748 | Paola Wellness LLC | Clinic/Center | 302 California Ave, Suite 202, Wahiawa, HI 96786-1841 | 2015-11-11 |
| 1851780621 | Kawamura Eye Care, LLC | Optometrist | 302 California Ave, Suite 102, Wahiawa, HI 96786-1841 | 2015-01-17 |
| 1891193397 | Jeremiah Shawn Brennan | Counselor | 302 California Ave, Suite 212, Wahiawa, HI 96786-1841 | 2014-12-15 |
| 1043646938 | Vichele A Tavares | Counselor | 302 California Ave, Suite 212, Wahiawa, HI 96786-1841 | 2013-09-24 |
| 1033551478 | Maile Mae Kawano Collado | Physical Therapist | 302 California Ave, Suite 202, Wahiawa, HI 96786-1841 | 2013-07-26 |
| 1285910158 | Elnora Waoala Hiers | Counselor | 302 California Ave, Wahiawa, HI 96786-1841 | 2011-10-24 |
| 1467773846 | Amber K. Gomes | Marriage & Family Therapist | 302 California Ave, Suite 212, Wahiawa, HI 96786-1841 | 2010-06-19 |
| 1104152743 | 21st Century Healthcare LLC LLC | Internal Medicine | 302 California Ave, Suite 209, Wahiawa, HI 96786-1841 | 2009-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801421870 | Macy Tiatti Coleman | Student in an Organized Health Care Education/Training Program | 683 Waianae Ave, Schofield Barracks, HI 96786 | 2020-03-10 |
| 1063078467 | Jacqueline Tommila | Registered Nurse | Wai'anae & Ayres Ave, Wahiawa, HI 96786 | 2019-05-13 |
| 1578126157 | Shantelle Caliboso Bautista | Registered Nurse | Wheeler Army Field, Wahiawa, HI 96786 | 2019-04-18 |
| 1679136246 | Dorinda A Ventura | Licensed Practical Nurse | 1 Wheeler Aaf Wahiawa, Hi 96786, Wahiawa, HI 96786 | 2019-04-18 |
| 1659853950 | Archnaben Patel | Physician Assistant | 3399 Glennan St, Wahiawa, HI 96786 | 2018-09-04 |
| 1245720564 | Zi Xiang Liu | Physician Assistant | 3399 Glennan Street, Schofield Barracks, HI 96786 | 2018-05-11 |
| 1417445503 | Kristine Wong | Occupational Therapist | 1034 Kilani Ave Ste 109, Wahiawa, HI 96786 | 2018-04-25 |
| 1467964528 | Hope Treatment Services | Counselor | 360 California Avenue, Wahiawa, HI 96786 | 2017-10-30 |
| 1881103919 | Testiny K J Mailo | Assistant Behavior Analyst | 1046 Eho Eho Avenue, #326, Wahiawa, HI 96786 | 2017-09-20 |
| 1982121059 | Salvador Mireles Thorn | Physician Assistant | U.S. Army Health Clinic Sb, Building 683, Schofield Barracks, HI 96786 | 2017-08-29 |
| Find all providers in zip 96786 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871076455 | Brian Vongchanphen Dds, LLC | Dentist | 810 Kilani Ave Ste A, Wahiawa, HI 96786-2044 | 2018-09-10 |
| 1811495336 | Jill Kanemaru-hwang Dds LLC | Dentist | 410 Kilani Ave Ste 221, Wahiawa, HI 96786-1844 | 2018-01-30 |
| 1265687776 | Jay Adam Cambra | Dentist | 612 Kilani Ave Fl 2, Wahiawa, HI 96786-1904 | 2008-11-25 |
| 1780849885 | Harold H Masunaga | Dentist | 960 Center St Ste 3, Wahiawa, HI 96786-2038 | 2008-07-28 |
| 1134263866 | Wesley Keiji Nihei | Dentist | 906 Kilani Ave, Wahiawa, HI 96786-2102 | 2007-02-16 |
| 1366594327 | Finn-white Dds Inc. | Dentist | 133 Westervelt St, Wahiawa, HI 96786-1929 | 2007-01-18 |
| 1972655769 | Craig Masao Kamisugi | Dentist | 935 California Avenue, Wahiawa, HI 96786 | 2007-01-18 |
| 1558424200 | Calvin M Kanemaru | Dentist | 410 Kilani Ave, Suite 221, Wahiawa, HI 96786-1844 | 2006-12-17 |
| 1932288008 | Wahiawa Family Dental Care, LLP | Dentist | 302 California Ave Ste 204, Wahiawa, HI 96786-1841 | 2006-11-02 |
| 1306955000 | Kerry S. Ishihara | Dentist | 810 Kilani Ave, Suite A, Wahiawa, HI 96786-2044 | 2006-08-29 |
| Find all providers in WAHIAWA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.